I went to the doctor

I went to the doctor and the doctor said son, you look older than me and I’m seventy-one.¹

I read somewhere that you should not go your GP with a list of symptoms.  One or two maybe, but not a shopping list.  Hmm; if I have to pick a just a couple…

I start with the recent cardiology clinic; that won’t count as a symptom.  He takes it all very seriously – he hasn’t yet had a letter from the hospital – when he does we’ll talk again.  I also mention the idea of a pacemaker to control the arrhythmia.  He explains patiently and clearly why this won’t work in my case.  What might work is an implantable cardioverter defibrillator (ICD).  This gives an electric shock to restore a fast rate back to normal.  It’s about the size of a matchbox and fitted under the collarbone.  But only for ‘high-risk’ patients.  I know nothing about ICDs so envisage a long Google session coming up.  If this does prove to be an option, I have plenty of space to fit one.

He knows I don’t like being stuck on bisoprolol, warfarin and flecanaide, but that’s just the way it is for now.  I tell him we’re going to Australia in a few weeks (to see Annie’s sister and catch up with her youngest son, Dan), so he makes sure I have enough medication for the duration.  Tick; another thing off the list.

He’s looking at my forehead; now I can mention a symptom.  Although this is somewhat redundant as he’s beaten me to it.  So I offer a diagnosis instead: “I assume it’s hormones”.  Earlier that morning I’d been staring in the bathroom mirror at an eruption about to take place just above my left eyebrow; my own pocket-sized Vesuvius.  The last time I had stood before a bathroom mirror looking at spots was about 50 years ago.  Is this teen-age angst all over again?  I resist the temptation to give it a hand.

It’s not just my forehead; my nose is also host to an outbreak.  It’s very red – and starting to look a bit like the sort of nose a person with a drink problem might have; if you’re old enough, think W.C. Fields.

“No – it’s probably the warfarin.  We may have to take you off it, if it gets too bad”.  I explain that I’ve tried using E45 cream, but to no avail.  He prescribes a heavy-duty alternative.

I check my list; apart from the physiognomic volcanic activity, I’m looking and feeling remarkably well.  So we leave it at that for now.  I consider myself lucky to have such a good GP.

…. I went to the doctor and the doctor said, kid it was something that you ate or drank, It’s something that you did …

Luck.  I have this thing about luck.  Not superstition, but the chance happenings that can sometimes make or break our lives.  I also believe that we can make our own luck to some extent; recognising an opportunity when it comes along.

I put the fallout from lung surgery down to bad luck.  That I needed lung surgery at all was nothing to do with luck, however.  That was simply a consequence of bowel cancer cells getting into my blood stream.  Once cancer cells break through the bowel wall, their progress towards other organs is inevitable.  First stop liver, next stop lungs.  This is not some random trip – cancer cells do not get out the travel brochures and have a think about where they might like to spend the summer.  The secondary sites of specific cancers appear to be already programmed in.  Further surgery or chemotherapy or radiotherapy can stop them in their tracks or slow them down.  But it doesn’t change the nature of the beast – it’s just what they do – like some malevolent homing pigeon, they have to follow their instincts.

But once they reach their destination organ, then luck does come into play.  If my left lung was, say, the United Kingdom, then they could fetch up in the car-park at John O’Groats or the teashop at Land’s End; that is, in some distant, quiet, unspoilt part of my respiratory system.  But no – they settle for the cardiovascular equivalent of Spaghetti Junction – just off the M6 and about as far inland as you can get.  A high-rise mess of nerves, veins and arteries.

And as anyone who has driven around the M6 will know – once you start digging, chaos and disruption on a major scale are inevitable.  Which is why I find myself under the care of an ENT consultant.

And now for the good luck part.  A few months ago – I can’t remember what prompted it – I found myself staring at a blank Google page.  My fingers are poised over the keyboard and I’m wondering where to go next.  I type in ‘ENT’ and end up with a glossary of various departments up and down the country.  There’s a hospital in Birmingham that specialises in the treatment of singers with vocal palsy.  I get quite excited about this – but at the same time, can’t help thinking – why am I only just finding out about this now?  Why didn’t someone tell me earlier?

Perhaps that’s a bit unfair, although ever since the lung surgery in June 2010, I’ve been banging on about getting a singing voice back to anyone who would listen.  I saw an old friend a few weeks ago who’s recovering from serious injury after being knocked off his bike.  He needs specialist treatment and is having to research a lot of it himself; “I don’t know how we managed before the internet”.  We didn’t I guess; we just took what was on offer and got on with it.

I mention the Birmingham clinic, as an aside, to the speech therapist at a routine appointment in January.  I almost didn’t bother, the events over Christmas having overshadowed anything I might be feeling about myself – but something brought it to mind as we were finishing the appointment.  The speech therapist knew all about it – apparently they can reach parts of the voice box that most other ENT clinics can’t.  Before I can say anything, she offers to ask Mr ENT if he would refer me to the consultant concerned.

I’m apprehensive about this; will Mr ENT refer me?  It’s not a slight on his expertise – far from it – but the techniques and procedures available are simply not within his compass.  Will they agree to see me?  The clinic information mentions treatment for ‘professional singers’.  Do I qualify?  A bucket passed round in a pub after a gig is not the same as a salaried position, even if it does contain £175 in coin of the realm.  And if they do agree to see me – will they be able to do anything?

Watch this space.  It’s all a matter of luck.

… I went to the doctor and the doctor said, shucks that’s just about all, you owe me 300 bucks,                                                                                                                                              And you can call me in the morning – that is if you’re not dead…

Chorus; oh, oh, oh, I went to the doctor ….


¹ From a song by Loudon Wainwright III
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2 Responses to I went to the doctor

  1. JJ says:

    ian I do hope the clinic goes well for you, although I must ask… will you end up with a Brummie accent when they have done with you , do you think???

    Not really meaning to hijack but to add weight to your comment about the internet and how we (professional cancer patients??) use it.
    The story starts a couple of years ago when (by some forgotten means) I came across the name of a chap who seemed to know a few things about the problems ladies with breast cancer have with their arms after surgery. I was interetsed as I have tightness in my chest/ armpit area.
    Digging round for lymph nodes in the armpit area tends to have a few knock on effects as there are nerves in the area (numbness or altered sensation or neuropathic pain) and also the lymph vessels dry up and for cords which can shrink, harden and tighten up. Commonly it leads to reduced range of movement in the shoulder joint as the tight cords prevent full stretch and in more extreme cases the lady starts walkign round doing a fair impression of Bonaparte. in 2001 I had this problem in extreme but through hard work I now have normal ROM.
    So, this chappy, I saved the link but couldnt find anything else and anyway he lived in South Africa which isnt on my normal commute.
    Fastforward to last year and I was in my annual checkup with yet another oncologist (DO they have a rule that says you never see the same chap twice?) he asks me how I am and my frustration at my arm prompts me to speak. Now I can move it well but I am conscious that I can feel the tightness and it bugs me. many would 9and have) argued how lucky i should be to be alive and that i do have good movement and there are many worse than me…blah,blah,I’ve stopped listening to the patient, blah,blah
    But I try again and mention myofascial release, the technique the S.African guy does.
    Onc thinks I mean a surgical technique but I deny this as I know its a manipulative/ physio type of thing
    he shakes hi head in ignorance and I leave, vowing to look again for this man and find some more info
    Ah Google, my dear friend, what can i find.
    A search does manage to find him this time and when I do i realise why I struggled before. He was referred to as Willie Fourie but his name is Willem. Its amazing what Google can find with the full info
    I got a name in the UK of a physio who organised his courses in the UK. So that means his techniques are available here. by email with her and the man himself I get pointed at a lady within 5 miles of my home.
    Then this weekend I volunteered to be his model on his connective tissue course and speak with him about my complaint.
    On examination he found what others havent bothered to look for.
    The other drs see the full arm movements up above the head and well up my back and stop listening to me or looking at me.
    He interrogates my body tissues by examination and finds the stubborn tissues (fascia) that resist gliding and that I feel as tightness.
    How wonderful to feel validated.
    The my knowledge of my own body and how it feels is not dismissed or deemed as irrelevant.

    So Ian, may your luck in finding out about this clinic also lead to a successful outcome for you.

    I wonder why i should feel that that is remarkable?

  2. Chris Read says:

    Hi Ian,
    Just a quick thank you for your blog .I am so glad to see you seem a lot more positive than some of your recent postings. This cheers me up no end as reading all you have been through and still retaining your sense of humor inspires me when I feel a bit depressed with my lot which is nothing to your experiences.Hope you have a fantastic trip down under and give the Aussies heaps.

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